About Washington University School of Medicine in St. Louis
Washington University Medical Center is one of the nation’s largest clinical and biomedical facilities. The campus includes more than 60 buildings and covers portions of 12 city blocks. Barnes-Jewish Hospital, the flagship hospital the BJC HealthCare system, is ranked among the top U.S. hospitals and is a nationally certified Level I Trauma Center with over 3,000 trauma admissions per year. At 1,100 beds, it is one of the largest hospitals in a multi-state region.
Barnes-Jewish Hospital is a tertiary referral center with a broad catchment area and a significant scope of influence. Our patient base arrives from the entire state of Missouri and parts of every bordering state: Iowa, Illinois, Kentucky, Tennessee, Arkansas, Oklahoma, Kansas, and Nebraska. The Charles F. Knight Emergency & Trauma Center (Adult) at Barnes-Jewish Hospital occupies the ground floor of a multistory building with surgical suites, radiology, laboratory and essential services located on upper floors. The Trauma Center receives 95,000 ED visits annually.
Section of Trauma Anesthesiology
The Section of Trauma Anesthesiology is part of the General Anesthesia Division and consists of faculty who specialize in the resuscitation and care of critically ill and injured patients. The Trauma Anesthesiology faculty have expertise in a variety of areas to include cardiac anesthesia, critical care, and military medicine. On a daily basis, our trauma anesthesiologists provide state-of-the-art preoperative care to patients with urgent/emergent surgical problems, in addition to managing and triaging cases and staff across all of the anesthetic locations at WashU. A member of the Trauma Anesthesia team is present for every level-one trauma admissions to the emergency department. Barnes-Jewish Hospital maintains a dedicated trauma operating room around the clock and staffed by an attending anesthesiologist with a CRNA or Resident/Fellow physician.
About the Fellowship
The fellowship in Trauma Anesthesiology at Washington University in St. Louis is one of only a few of its kind in the United States. The fellowship is a 12-month program and consists of OR rotations, ICU rotations, and elective rotations, as well as nonclinical time and time set aside for self study, meetings/conferences, and educational activities. Seven months are devoted to OR anesthesia on the Trauma Anesthesia Service, focusing on preoperative clinical care, supervision of residents in anesthesiology, and administrative/triage management of the ORs. During this time fellows will focus on caring for patients with acute traumatic injuries to the head, chest, abdomen/pelvis, spine, and extremities, urgent/emergent surgeries, as well as patients under Acute/Critical Care Surgery, Orthopedic Trauma, Vascular, ENT, and Neurosurgery. In addition, two months are spent as a Critical Care Fellow, managing critically ill patients in both the Neuro ICU and Surgical ICU. Electives compose the rest of the year and are meant to allow the fellow to learn a specialized skill or knowledge base from the trauma perspective. These rotations include Blood Bank/Transfusion Medicine, Critical Care Ultrasound/TEE, ER Radiology, Regional Anesthesiology, and Prehospital Management. Furthermore, fellows are also able to choose to participate in global health projects being offered by the Department of Anesthesiology if available. It is expected that the trauma fellow will have obtained ATLS certification at both the provider and instructor level and can be eligible to obtain basic echocardiography certification. Additionally, the fellow will participate in departmental grand rounds as well as trauma service meetings and conferences.
The fellow’s schedule is flexible, on average consisting of 16 shifts/month, which are served primarily alongside the Trauma Anesthesia attending. This time is split between supervision of CRNAs and residents or personally providing anesthesia for Acute Care Surgery, Orthopedic trauma, and neurosurgical patients, while also being available for any urgent/emergent trauma cases that may occur throughout the day. In addition to clinical responsibilities, the trauma fellow assists with the administrative duties of OR staff management and triage, deciding what cases to start and hold based on OR workload and demand.
The Trauma fellow is expected to see any trauma patients that arrive at the Emergency Department during their shift, along with a Trauma Anesthesia attending and Trauma Surgery colleagues. During the initial assessment, the fellow can participate alongside Emergency Medicine and Surgery staff in the work-up and management of the acute trauma patient, from airways, line placement, resuscitation, imaging, and transport to the operating room.
The Trauma fellow is an active participant in both Trauma Anesthesiology education conferences and activities throughout the year, as well as conferences and activities conducted through the Department of Anesthesiology. The fellow plays an integral role in teaching residents during their Trauma Anesthesia rotations, including journal clubs, case conferences, as well as clinical teaching, both in our simulation center and in the ORs. Fellows are assigned one non-clinical day per week to provide time to work on projects and education. The fellow will also be given five meeting days, to be used at their discretion throughout the year to attend local, regional, national, or international conferences related to trauma care. In addition, fellows are given 15 days of vacation time each year, as well as a $1,500 discretionary fund by the department.